A. A sudden onset of high fever (102 degrees and higher) is one of the most common reasons to call or seek pediatric advice or visit. Lower fevers may still be serious, and you can call your pediatrician if you are concerned.

Q. When is vomiting serious?

A. Repeated, frequent vomiting over several hours, especially with copious amounts, may result in dehydration. If more body fluids are lost with accompanying diarrhea, the fluid balance/dehydration may become critical, requiring urgent attention. Call your pediatrician, or after hours go to the emergency room at the hospital or prompt care facility.

Q. When should you seek a pediatrician when the child is coughing?

A. When a cough is frequent, persistent and associated with a high fever, a visit to the pediatric office should be urgent. This is especially true if the infant or child has signs of significant respiratory distress like rapid and shallow breathing, grunting, wheezing audible to the ear or stridor.

Q. What about trouble breathing?

A. Trouble breathing can lead to respiratory failure, which may follow a quick course or more time. However, the ultimate outcome of unattended respiratory failure is failure of vital organs and death. Therefore, situations like severe asthma, spasmodic croup or foreign body aspirations are true emergencies in which parents should seek help immediately. In my practice, these patients can be seen anytime during office hours. No appointments needed.

Q. When should parents take dehydration seriously?

A. (When there is) any lack of voiding urine for more than 12 hours, dry mouth or being very thirsty despite vomiting. The parent might also see poor circulation that includes cold, mottled skin that feels like dough. They might be drowsy, sleepy, be limp, and any or all of these signs are serious. Parents are encouraged to seek help even when in doubt.

Q. What if your child is hard to wake up?

A. Parents are advised to call and have the child assessed immediately. In past years, when bacterial meningitis has occurred, immediately seeking a physician was the best course of action. Presently, the vaccines have about eliminated them, but still give children immediate attention.

Q. When should parents check with pediatricians involving a rash?

A. Very few, if any, rashes are serious. However, they are annoying to children and parents. In the summer, rashes include poison ivy, and bug bites or sunburn are an issue if they become infected.

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Sometimes urticaria or hives are a problem. Lately, a resurgence of skin abscesses due to methicillin-resistant staphylococcus aureus (MRSA) has been seen. Yet, most of the time there is no need to seek urgent care when it comes to rashes. If you have questions or are concerned about a rash, call your physician or pediatrician for answers.

Q. What are some other situations when parents should call a pediatrician?

A. Most of these situations relate to sudden problems: trauma, accidents, ingestions (accidental or intentional).